Missouri

On July 14, the MO HealthNet Pharmacy Program transitioned the Preferred Drug Searchable Database to a new vendor. If the new database is unavailable, providers may use the Pharmacy Clinical Edits and Preferred Drug Lists webpage. 

Also in Missouri, MO HealthNet Division (MHD) will begin desk audits of providers to ensure proper billing units are used for drugs billed to MO HealthNet. Providers are responsible for proper billing of claims as outlined in Section 15 of the Pharmacy Provider Manual. Providers must have adequate documentation and these records must be made available to MO HealthNet upon request. 

Also in Missouri, announced provider rate increases contingent on CMS approving the State Plan amendment (SPA). Until then, current rates remain in effect. 

Finally in Missouri, Gov. Mike Parsons (R) signed into law two opioid bills effective August 28, 2022. HB 2162 expands the definition of opioid antagonists that can be dispensed under a prescriber’s protocol or standing order to include addiction mitigation medications, and MO HB 2331 allows a pharmacist to dispense and opioid antagonist under a protocol or standing order. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2022-07-22T11:41:28-04:00July 22, 2022|Missouri|

New Mexico

The Medical Assistance Division (MAD) of the New Mexico Human Services Department (HSD) is requiring all prescribers including pharmacists with prescriptive authority for Centennial Care members to enroll as a Medicaid Provider by November 12, 2022, to continue to receive payment for prescriptions. Failure to enroll as a Medicaid Provider will result in denial, rejection, or recoupment of payment for prescriptions when written for Centennial Care members.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2022-07-22T11:40:57-04:00July 22, 2022|New Mexico|

New York

As a result of PBM legislation enacted in 2021, the NYS Department of Financial Services is developing regulations, and the Department is seeking public comment on a series of issues.  

Below are the three upcoming Public Notices with links for more details related to: 

PBM Services to Medicare Part D Plans, Comments due August 1, 2022  

View the Request for Public Comments (PDF) Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-02” included in the subject line. Failure to include “PBM2022-02” in the subject line may result in your comment not being considered. The deadline for responses is August 1, 2022.  

Reporting Requirements for PBMs (Pharmacy Benefits Managers), Comments due August 5, 2022 

View the Request for Public Comments (PDF) Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-03” included in the subject line. Failure to include “PBM2022-03” in the subject line may result in your comment(s) not being considered. The deadline for responses is August 5, 2022. 

Practice of Patient Steering by PBMs due August 19, 2022 

View the Request for Public Comments (PDF) Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-04” included in the subject line. Failure to include “PBM2022-04” in the subject line may result in your comment not being considered. The deadline for responses is August 19, 2022.  

For more information about these Public Notices and DFS (Department of Financial Services) efforts to implement the law, please click here. 

Also in New York, the Office of the Medicaid Inspector General (OMIG) published a Proposed Rule Making in the State Register related to Medicaid Program Fraud, Waste and Abuse Prevention with the stated purpose to establish requirements for providers to detect and prevent fraud, waste, and abuse in the Medicaid Program.  

The full text of the proposed rule can be found here. Public comments are due within 60 days from when published on July 13, 2022. To read the new sections added to OMIG regulation through this rulemaking in their entirety, please click here. 

In particular, the proposed rulemaking would repeal and add a new 18 NYCRR Part 521 to implement statutory changes resulting from the recommendations of the Medicaid Redesign Team II as adopted in the State Fiscal Year 2020-2021 Enacted Budget (Chapter 56 of the Laws of 2020, Part QQ) and to make other conforming changes related to: 

(1) Provider Compliance Programs,  

(2) Medicaid Managed Care Plan fraud, waste, and abuse prevention programs under the Medical Assistance (Medicaid) program, and  

(3) The Obligation to report, return and explain Medicaid overpayments through OMIG’s Self-Disclosure Program.  

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

2022-07-22T11:40:24-04:00July 22, 2022|New York|

Ohio

The Ohio Department of Medicaid (ODM) announced that the enhanced COVID-19 administration reimbursement rate for pharmacies will end on Sept. 30, 2022, as the new Single Pharmacy Benefits Manager (SPBM) program takes effect.  

Also in Ohio, the Board of Pharmacy issued guidance on the implementation of HB 193, which mandates electronic prescribing of Schedule II controlled substances. As the guidance notes, the law has a “safe harbor” provision which allows pharmacies to continue to fill paper prescriptions without verifying that the prescriber has an exemption. The law goes into effect on Sept. 23, 2022. Special thanks to the Ohio Council of Retail Merchants for working with NACDS and members during the legislative process to ensure that the “safe harbor” provision was included in the law. 

Also in Ohio, the Board of Pharmacy posted a notice regarding license renewals for Certified Pharmacy Technicians. The renewal process opens on Aug. 1, 2022. 

Finally in Ohio, the following are updates/reminders on the topic of the upcoming October implementation of the SPBM: 

  • To request a spreadsheet on the new dispensing fees by store location, please email medicaidspbm@medicaid.ohio.gov and include a list of your store NPI numbers. 
  • ODM sent a bulletin to pharmacies reminding them of important upcoming deadlines to participate in the SPBM program. 
  • On August 3, 2022, the Cost of Dispensing survey that will be used to set rates in both the Fee for Service and the SPBM Managed Care programs be sent out to all enrolled Medicaid pharmacies by both US Mail as well as email, if ODM has an email for the pharmacy on record. Surveys are due back on September 14, 2022. Here is a copy of the draft survey instrument.
  • Myers & Stauffer will host two instructional cost of dispensing survey webinars on Aug. 11 at 3:00 PM and Aug. 16 at 8:30 AM. Information to register for the webinars will be included in the survey packet sent to pharmacies. A draft of the dispensing survey tool can be viewed here.  
  • For a list of specialty drugs and ingredient cost reimbursement by drug (OAAC (Ohio Average Acquisition Cost)) please visit the Myers & Stauffer Ohio Medicaid webpage. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

2022-07-22T11:39:31-04:00July 22, 2022|Ohio|

Oklahoma

The State Board of Pharmacy (OSBP) is requesting that pharmacies email the following information within 24 hours of pharmacy closure during normal business hours, during the time when patients would expect the pharmacy to be open.  

  • License number of the pharmacy 
  • Name of the pharmacy 
  • Address of the pharmacy 
  • Name of the Pharmacist in charge (PIC)
  • Dates that the pharmacy will be closed 
  • Hours the pharmacy will be closed 
  • Detailed explanation for closing 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2022-07-22T11:38:45-04:00July 22, 2022|Oklahoma|

Oregon

The Oregon State Newsletter – June 2022 has been posted to the NABP/Oregon website and includes the following information. 

  • No. 678 Safe Pharmacy Practice Conditions 
  • No. 679 Expedited Partner Therapy Updates 
  • No. 680 Rulemaking
  • Rule Feedback 
  • Permanent Rules Adopted in April 2022
  • Permanent Rules Adopted in June 2022
  • No. 681 Compliance: Legal Advice vs Legal Information 
  • No. 682 Licensing: Technician Renewals Due June 30, 2022 
  • No. 683 REALD and Pharmacies 

Also in Oregon, the Board of Pharmacy adopted the following temporary rules effective July 1, 2022, through December 27, 2022. 

  • OAR 855-019-0210 related to Duties of Pharmacist Receiving a Prescription  
  • OAR 855-139-0699 related to a Retail Drug Outlet RDSP (Remote Dispensing Site Pharmacy) 

Also in Oregon, the Board of Pharmacy adopted the following permanent rules at the June 2022 Board Meeting. 

Finally in Oregon, effective July 1, 2022, through December 27, 2022, the Oregon Health Authority adopted a temporary rule amending OAR 410-121-0030 and 410-121-0040 in accordance with the Drug Use Review (DUR) Pharmacy & Therapeutics (P&T) Committee’s recommendations made during the June 2, 2022 meeting.   

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

2022-07-22T11:37:46-04:00July 22, 2022|Oregon|

South Carolina

The South Carolina Pharmacy Association (SCPhA) is seeking a new Chief Executive Officer. The selection process will begin in July 2022 and continue until the best candidate is identified. Questions may be directed to the Selection Committee c/o Jennifer Baker, SCPhA Immediate‐Past President & Search Committee Chair at scpharmacyjlb@gmail.com

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

2022-07-22T11:36:06-04:00July 22, 2022|South Carolina|

Texas

The Board of Pharmacy August 2nd meeting agenda includes proposed rules for final adoption on patient counseling, non-sterile compounding, and centralized prescription dispensing. If you are unable to attend the Board meeting, you can watch it on live stream.  

Also in Texas, NACDS sponsored the Texas Pharmacy Association’s annual meeting keynote session with State Senator Charles Perry (R-Lubbock), the Vice-Chair of the powerful Senate Health and Human Services Committee. Last session, Sen. Perry, a vocal advocate for pharmacy benefit manager (PBM) reform, helped pass two important bills through the Senate that became law in 2021.  

Also in Texas, NACDS and our in-state partner, the Texas Federation of Drug Stores, have arranged for Rep. Four Price (R) to tour a United Supermarket Pharmacy in Amarillo. (Left to Right: United pharmacist Tim Purser, pharmacy technician Danielle Coleman, pharmacist Viet Le Nguyen, NACDS’ TX lobbyist Nicole Kralj, State Rep. Four Price (R-Amarillo) and NACDS Mary Staples) 

Finally in Texas, Gov. Greg Abbott (R) again extended the waiver for the requirement for pharmacists to have in-person contact for patient counseling to allow patient counseling to be performed by telephonic consultation until September 30, 2022, or until the March 13, 2020, disaster declaration is lifted or expires, whichever is earlier.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2022-07-22T11:35:32-04:00July 22, 2022|Texas|

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